ArticleAIDS (London, England)2017
Risk factors for early mortality on antiretroviral therapy in advanced HIV-infected adults.
Article in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Tuberculosis preventive therapy for people living with HIV: A systematic review and network meta-analysis.PLoS medicine · 2021Pooled it
- HIV-Related Arterial Stiffness in Malawian Adults Is Associated With the Proportion of PD-1-Expressing CD8+ T Cells and Reverses With Antiretroviral Therapy.The Journal of infectious diseases · 2019Trial
- As-Needed Vs Immediate Etoposide Chemotherapy in Combination With Antiretroviral Therapy for Mild-to-Moderate AIDS-Associated Kaposi Sarcoma in Resource-Limited Settings: A5264/AMC-067 Randomized Clinical Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Trial
- Late Presentation With HIV in Africa: Phenotypes, Risk, and Risk Stratification in the REALITY Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Trial
- Blood neutrophil counts in HIV-infected patients with cryptococcal meningitis: Association with mortality.PloS one · 2018Trial
- Characteristics of Individuals With Advanced HIV Disease and Risk Factors for Mortality in a Contemporary Cohort in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Article
- Diagnosis and Management of Kaposi Sarcoma-Associated Herpesvirus Inflammatory Cytokine Syndrome in Resource-Constrained Settings: A Case Report and an Adapted Case Definition.Tropical medicine and infectious disease · 2024Article
- Evaluation of Treatment Outcomes Among Individuals on Highly Active Antiretroviral Therapy in KwaZulu-Natal, South Africa.AIDS research and treatment · 2024Article
- Nutritional risk and HbA1c as critical risk factors and predictors of opportunistic infections in HIV-DM comorbid patients: a retrospective cross-sectional study.Frontiers in endocrinology · 2024Article
- Do private providers initiate anti-tuberculosis therapy on the basis of chest radiographs? A standardised patient study in urban India.The Lancet regional health. Southeast Asia · 2023Article
- Effect of the relationship between anaemia and systemic inflammation on the risk of incident tuberculosis and death in people with advanced HIV: a sub-analysis of the REMEMBER trial.EClinicalMedicine · 2023Article
- Modelling the impact of CD4 testing on mortality from TB and cryptococcal meningitis among patients with advanced HIV disease in nine countries.Journal of the International AIDS Society · 2023Article
- Persistent High Burden and Mortality Associated With Advanced HIV Disease in Rural Tanzania Despite Uptake of World Health Organization "Test and Treat" Guidelines.Open forum infectious diseases · 2022Article
- Use of Tenofovir Alafenamide/Emtricitabine/Elvitegravir-Cobicistat in HIV-Naive Patients with Advanced Disease: GENIS Study.Journal of clinical medicine · 2022Article
- Xpert Ultra testing of blood in severe HIV-associated tuberculosis to detect and measure Mycobacterium tuberculosis blood stream infection: a diagnostic and disease biomarker cohort study.The Lancet. Microbe · 2022Article
- Early mortality in a cohort of people living with HIV in Rio de Janeiro, Brazil, 2004-2015: a persisting problem.BMC infectious diseases · 2022Observational
- Causes of death and associated factors over a decade of follow-up in a cohort of people living with HIV in rural Tanzania.BMC infectious diseases · 2022Article
- Construction and validation of a prognostic nomogram for predicting the survival of HIV/AIDS adults who received antiretroviral therapy: a cohort between 2003 and 2019 in Nanjing.BMC public health · 2022Article
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Authors and funding
22 authors.
Funding
Abstract
backgroundMany HIV-infected individuals present with advanced HIV disease. These patients are at high risk of death after antiretroviral therapy (ART) initiation, but risk factors for death in these patients are unclear.
methodsWe used data from a multisite randomized trial comparing empiric vs. preventive tuberculosis therapy in HIV-infected adults initiating ART with CD4 T-cell counts less than 50 cells/μl to evaluate risk factors for death within 48 weeks after ART initiation. Cox proportional hazards models were fit to evaluate characteristics present at baseline and at 4 weeks after ART initiation, including the week 4 CD4 T-cell response and new opportunistic infections.
resultsOf 850 enrolled, the median pre-ART CD4 T-cell count was 18 cells/μl and 67 (7.9%) died. Baseline risk factors for death included lymphadenopathy, lower CD4 T-cell count, lower serum albumin, high white blood cell count, elevated neutrophil percentage, and lower hemoglobin. Among 746 participants with data at week 4, the median changes in CD4 T-cell count and viral load for those who died (n = 43) vs. survived were 26 vs. 56 cells/μl and -2.7 vs. -2.7 log10 copies/ml, respectively. Each 20 cell/μl lower change in week 4 CD4 T-cell count was associated with a 20% increased risk of post week-4 mortality (adjusted hazard ratio 1.20, 1.01-1.42, P = .038).
conclusionEvidence of active infection and suboptimal immunologic response during the first month of ART are associated with death in the first year after ART initiation in those with advanced HIV disease taking tuberculosis preventive therapy. Strategies to reduce early mortality in this population warrant further investigation.
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